Rural communities have long used donkey-drawn carts to take the sick to health clinics "but when this is the official, state-provided service, you have to be worried," he said.

However, one international health official told BBC News Online that it was unfair to blame the government entirely for the crisis in the health system.

"Aids and structural adjustment policies, which led to the introduction of users fees also played a part," she said.

She added that the ox-drawn ambulances were the "appropriate technology" for remote rural areas, where people may not be able to access fuel or spare parts for motor vehicles.

Distant clinics

The ox-drawn ambulances were donated by the United Nations Children's Fund, Unicef, following a request from the Zimbabwe government.

Maternal mortality has increased from 283 per 100,000 live births in 1994 to 695 per 100,000 births in 1999.

"The gains made over the last 20 years to address maternal mortality, especially to provide emergency obstetric care services, are at risk of being lost," said Dr Juan Ortiz, Chief of the Health, Nutrition and Environment Section at Unicef.

"We know that most of the complications related to childbirth are preventable if obstetric services are available, especially in remote areas," he said.

Unicef officials say that the ambulances could indeed save many lives as Zimbabwe's rural women live an average of 10km from the nearest health facility.